Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants-A Pilot Study

Area of Science:

• Pediatric Gastroenterology
• Neonatology
• Speech-Language Pathology

Background:

• Dysphagia assessment in preterm infants traditionally relies on clinical evaluation and VFSS.
• Fiberoptic endoscopic evaluation of swallowing (FEES) is emerging as an alternative, but comparative diagnostic utility is unclear.
• The benefit of combining VFSS and FEES simultaneously for dysphagia detection in preterm infants remains unexplored.

Purpose of the Study:

• To assess the feasibility of performing simultaneous VFSS and FEES in preterm infants.
• To determine if combined VFSS-FEES enhances diagnostic accuracy for dysphagia compared to individual tests.
• To evaluate the sensitivity and specificity of the combined procedure for detecting penetration and aspiration.

Main Methods:

• A pilot study involving five preterm infants (postmenstrual age ≥36 weeks) with dysphagia.
• Simultaneous VFSS and FEES were performed, analyzing 26 linked swallows.
• Comparison of diagnostic yield for penetration and aspiration between combined and individual test methods.

Main Results:

• Simultaneous VFSS-FEES was found to be feasible and well-tolerated in preterm infants.
• The combined procedure demonstrated improved detection of penetration compared to VFSS or FEES alone.
• A low incidence of aspiration but a high incidence of penetration was observed in the study cohort.

Conclusions:

• This study is the first to report the feasibility of simultaneous VFSS-FEES in symptomatic preterm infants.
• The combined approach shows potential for a higher diagnostic yield in identifying dysphagia.
• Further research is warranted to confirm the enhanced diagnostic capabilities of simultaneous VFSS-FEES.